vigilcare-clinical/VigilCareClinicalAPI/Services/SepsisBundleService.cs

using System.Text.Json;
using Microsoft.EntityFrameworkCore;

public class SepsisBundleService : ISepsisBundleService
{
    private readonly AppDbContext _db;
    private readonly IOrderService _orderService;
    private readonly ClinicalMetrics _metrics;

    public SepsisBundleService(AppDbContext db, IOrderService orderService, ClinicalMetrics metrics)
    {
        _db = db;
        _orderService = orderService;
        _metrics = metrics;
    }

    public async Task<SepsisBundle?> TryCreateBundleAsync(
        Guid encounterId, Guid triggeringAlertId, AlertType alertType, CancellationToken ct = default)
    {
        if (alertType != AlertType.SofaSepsis)
            throw new InvalidOperationException(
                $"Sepsis bundle can only be triggered by SOFA_SEPSIS, not {alertType.ToDbString()}.");
                
        var exists = await _db.SepsisBundles
            .AnyAsync(b => b.EncounterId == encounterId
                && b.ComplianceStatus == SepsisBundleComplianceStatus.InProgress, ct);

        if (exists)
            return null;

        var recognizedAt = DateTimeOffset.UtcNow;
        var bundle = new SepsisBundle
        {
            Id = Guid.NewGuid(),
            EncounterId = encounterId,
            TriggeringAlertId = triggeringAlertId,
            TriggeringAlertType = alertType.ToDbString(),
            RecognizedAt = recognizedAt,
            DeadlineAt = recognizedAt.AddHours(1),
            ComplianceStatus = SepsisBundleComplianceStatus.InProgress
        };

        var elementDefs = new (SepsisBundleElementType Type, OrderType OrderType, string Description)[]
        {
            (SepsisBundleElementType.BloodCultures,            OrderType.Lab,        "SEP-1: Blood cultures"),
            (SepsisBundleElementType.SerumLactate,             OrderType.Lab,        "SEP-1: Serum lactate"),
            (SepsisBundleElementType.BroadSpectrumAntibiotics, OrderType.Medication, "SEP-1: Broad-spectrum antibiotics"),
            (SepsisBundleElementType.IvFluidResuscitation,     OrderType.Procedure,  "SEP-1: IV fluid bolus"),
        };

        foreach (var (elementType, orderType, description) in elementDefs)
        {
            var order = await _orderService.CreateAsync(encounterId, new CreateOrderRequest(
                orderType, description, "sepsis-bundle-engine"));

            bundle.Elements.Add(new SepsisBundleElement
            {
                Id = Guid.NewGuid(),
                ElementType = elementType,
                Status = SepsisBundleElementStatus.Pending,
                OrderId = order.Id
            });
        }

        _db.SepsisBundles.Add(bundle);

        _db.OutboxEvents.Add(new OutboxEvent
        {
            Id = Guid.NewGuid(),
            Topic = "sepsis.bundle.created",
            Payload = JsonSerializer.Serialize(new
            {
                bundleId = bundle.Id,
                encounterId,
                triggeringAlertId,
                triggeringAlertType = alertType.ToDbString(),
                recognizedAt,
                deadlineAt = bundle.DeadlineAt,
                partitionKey = encounterId.ToString()
            }),
            PartitionKey = encounterId.ToString(),
            CreatedAt = DateTimeOffset.UtcNow
        });

        await _db.SaveChangesAsync(ct);
        return bundle;
    }

    public async Task<SepsisBundle?> GetCurrentByEncounterAsync(Guid encounterId)
    {
        return await _db.SepsisBundles
            .AsNoTracking()
            .Include(b => b.Elements)
                .ThenInclude(e => e.Order)
            .Where(b => b.EncounterId == encounterId)
            .OrderByDescending(b => b.RecognizedAt)
            .FirstOrDefaultAsync();
    }

    public async Task<SepsisBundle> GetByIdAsync(Guid id)
    {
        var bundle = await _db.SepsisBundles
            .AsNoTracking()
            .Include(b => b.Elements)
                .ThenInclude(e => e.Order)
            .FirstOrDefaultAsync(b => b.Id == id);

        if (bundle is null)
            throw new NotFoundException("Sepsis bundle not found.", "BUNDLE_NOT_FOUND");

        return bundle;
    }

    public async Task OnOrderResultedAsync(Guid orderId, CancellationToken ct = default)
    {
        var element = await _db.SepsisBundleElements
            .Include(e => e.Bundle)
            .FirstOrDefaultAsync(e => e.OrderId == orderId, ct);

        if (element is null || element.Status == SepsisBundleElementStatus.Completed)
            return;

        element.Status = SepsisBundleElementStatus.Completed;
        element.CompletedAt = DateTimeOffset.UtcNow;

        var bundle = element.Bundle;
        var allComplete = await _db.SepsisBundleElements
            .Where(e => e.BundleId == bundle.Id && e.Id != element.Id)
            .AllAsync(e => e.Status == SepsisBundleElementStatus.Completed, ct);

        if (allComplete)
        {
            bundle.CompletedAt = DateTimeOffset.UtcNow;
            bundle.ComplianceStatus = bundle.CompletedAt <= bundle.DeadlineAt
                ? SepsisBundleComplianceStatus.Compliant
                : SepsisBundleComplianceStatus.NonCompliant;

            _metrics.SepsisBundleComplianceTotal
                .WithLabels(bundle.ComplianceStatus.ToDbString()).Inc();
        }

        _db.OutboxEvents.Add(new OutboxEvent
        {
            Id = Guid.NewGuid(),
            Topic = "sepsis.bundle.updated",
            Payload = JsonSerializer.Serialize(new
            {
                bundleId = bundle.Id,
                encounterId = bundle.EncounterId,
                elementId = element.Id,
                elementType = element.ElementType.ToDbString(),
                elementStatus = element.Status.ToDbString(),
                complianceStatus = bundle.ComplianceStatus.ToDbString(),
                completedAt = element.CompletedAt,
                partitionKey = bundle.EncounterId.ToString()
            }),
            PartitionKey = bundle.EncounterId.ToString(),
            CreatedAt = DateTimeOffset.UtcNow
        });

        await _db.SaveChangesAsync(ct);
    }
    
}